HON ALISON XAMON (North Metropolitan) [10.10 pm]: I rise having been inspired by starting to read some of the annual reports that have been tabled recently and also by having read a number of reports that have come out on prisons. As a result, I want to make some comments about the status of services in prisons at the moment. I could talk about many of them. I frequently talk about my concerns about psychological and psychiatric services, health services and access to training, but tonight I particularly want to make some comments about the appalling state of dental services within prisons. What specifically prompted me to speak tonight was the recent tabling of the annual report of the Melaleuca Remand and Reintegration Facility. I will get to that report shortly.

We know that dental services are not an add-on; they are absolutely essential. They are critical to overall health and wellbeing and quality of life. Dental care is not just about enabling people to perform the basic function of eating; it is also about ensuring that people are better able to speak and socialise without pain, discomfort or embarrassment. The impacts of poor oral health can be quite pervasive. People may not realise just how comprehensively it can impact on overall physical health. It is directly associated with compromised nutrition, which impairs general health. Of particular concern for prisoners is that it can exacerbate existing health conditions, of which they tend to have a disproportionately high number. Tooth infections can also spread to other parts of the body, including the brain, the heart and sinuses. There are associations between chronic oral infections and lung disease, heart disease and stroke. This tells us that basic dental health care is absolutely essential to ensuring that prisoners are able to successfully reintegrate into society upon their release from prison and also that poor oral health and subsequent tooth loss can impact on the ability of prisoners to find employment.

We already know that the oral health of prisoners tends to be poor and that prisoners are already likely to have extensive periodontal disease and other issues associated with their teeth. We also know that drug use can have a serious impact on dental health. Members would be familiar with the effects of long-term meth use, which can be devastating and contribute to what we know as meth mouth. That is not only due to the direct impact of the drug, but also to the tendency of long-term users to neglect their oral hygiene as they neglect their overall health. As we know, meth use is high among prison populations, with up to 50 per cent of prison entrants having used meth in the previous 12 months. I have heard the quite erroneous myth that prisoners have better access to health care than the general population. This is absolutely not the case. However, I acknowledge that general access to dental health care in the community, particularly for people on low incomes, is poor, and that is a huge problem. But prisoners have even worse access to health care and they do not even have an option to access private dental health care. Even if they did have the capacity to pay for that care, they cannot pay for the escort to access those particular services. It is not an option for prisoners in any real way. We know that we have to start prioritising dental care in our prisons because if we do not treat teeth in time, effectively they become impossible to save.

Reports are telling us that there are significant backlogs in our prisons. For example, a recent Office of the Inspector of Custodial Services report identified abacklog of 90 prisoners needing dental services at Albany Regional Prison. At the time of reporting, the dentist had only just cleared the waiting list from 2016. That gives an idea of how far behind we are. As a result, nurses were having to treat dental issues simply with antibiotics and painkillers. The situation is not limited to Albany. The issue of inadequate dental care with long waiting lists and high rates of prisoner complaints has been a constant theme if one goes through the OICS reports, as I do. A report delivered in December 2017 noted that the lack of dental services at Bandyup Women’s Prison was a common source of complaint and fell significantly short of community standards. There is no dental service at Broome Regional Prison. Prisoners needing dental work have to be transferred to West Kimberley Regional Prison, yet even at that prison there are enormously long waiting lists. Although a dentist is scheduled to visit the prison once a fortnight, last year they ended up attending only about 15 times. During an inspection in August last year, some patients had been waiting since November 2016 just for an initial assessment. This situation exists despite the fact that many people in West Kimberley Regional Prison have very poor dental health.

This is an issue in not just our public prisons. As I mentioned, there are problems in the Melaleuca Remand and Reintegration Facility. In 2017, it was found that prisoners had no access to specialist dental services. This has been described by OICS as grossly inadequate. Corrective Services was called on to ensure that this was urgently addressed. What I am finding particularly frustrating is that despite the issue having been identified by the inspector last year, it still had not been addressed in time for the most recent release of the prison’s 2017–18 annual report. That is why I am standing here. According to that annual report, procedures between Melaleuca and Bandyup relating to the transfer of women to receive dental treatment have still not been finalised, nor have procedures for a whole range of other things, by the way, such as pregnancy or the general transfer of prisoners between these prisons, but I am focusing on dental care today. As members will be aware, Melaleuca is a privately run prison. The annual report makes for some pretty concerning reading more broadly. It details a range of ongoing shortcomings, including in a whole bunch of other areas around education, vocational education and training and offender programs. I note that in 2017–18, the government issued Sodexo with 12 performance improvement notices across a range of areas, including incident reporting, restraining orders, family days and key security. In addition, 11 abatement notices of between $15 000 and $50 000 were issued for matters including failure to report and failure to comply with PINs. Clearly, access to dental treatment is not the only issue at Melaleuca, although that will perhaps need to be a discussion for another time.

Prison should be and needs to be an opportunity to address the physical, dental and mental health needs of a group of people who often come in profoundly disadvantaged. Importantly, it needs to be an opportunity for people who are most likely to be released to have the best opportunity to be rehabilitated and successfully reintegrated into the community. As OICS has demonstrated so clearly time and again, we are absolutely failing to utilise this opportunity. It is extremely disappointing to see this issue repeatedly being the subject of OICS recommendations and repeatedly not being acted upon. We know that improving access to general health care for prisoners, including, importantly, dental care, goes a long way towards improving prisoner health and public health. It is a key part of ensuring that prisoners have the best opportunity to successfully reintegrate upon release. Frankly, it is an area in which we are going to have to start lifting our game.


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